$TXT Created by CPRSNGUIB.DOMAIN.EXT (KIDS) on Friday, 02/13/26 at 10:09 ============================================================================= Run Date: JUL 21, 2026 Designation: OR*3*582 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #541 Status: Released Compliance Date: AUG 21, 2026 ============================================================================= Associated patches: (c)PSJ*5*436 install with patch `OR*3*582' (c)PSO*7*695 install with patch `OR*3*582' (v)OR*3*414 <<= must be installed BEFORE `OR*3*582' (v)OR*3*469 <<= must be installed BEFORE `OR*3*582' Subject: MOST RECENT LAB RESULTS SEARCH ISSUE Category: - Routine - Other Description: ============ This patch is being released in support of the following patches: PSJ*5.0*436 PSO*7.0*695 These changes are to correct a situation where Glucophage - Lab Results order check logic may fail to utilize the most recent Creatinine lab results if the most recent result was entered as an alphanumeric value. The specific changes include the ability to utilize alphanumeric lab result values, the ability to perform a numeric comparison with alphanumeric results in order to evaluate the Order Check, and the ability to display an appropriate message when the Order Check is unable to utilize the alphanumeric lab result in the Order Check evaluation. EHRM Impact Statement: ---------------------- This patch should have no EHRM impact, and can be installed at all sites, including EHRM converted sites. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File Number New/Modified/Deleted --------- ----------- -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- New File Entries Associated: File Name (Number) Field (Number) Value ------------------ --------------- ----- ORDER CHECK ELEMENT NAME (#.01) GLUCOPHAGE CREATININE (#860.3) INVALID IS TRUE ELEMENT CONTEXT (#.02) DATABASE LOOKUP CONDITIONAL EXPRESSION (#1) EXPRESSION SEQUENCE 1 NUMBER (#.01) DATA FIELD 1 (#1) RECENT GLUCOPHAGE CREATININE INVALID OPERATOR/FUNCTION LOGICAL TRUE (#2) ORDER CHECK DATA NAME (#.01) RECENT GLUCOPHAGE FIELD (#860.4) CREATININE INVALID DATA SOURCES (#100) DATA CONTEXT (#.01) DATABASE LOOKUP DATA SOURCE (#.02) DATABASE LOOKUP META DICTIONARY PATIENT.GLUCOPHAGE_CREAT_ LINK (#1) INVLD DATATYPE (#101) BOOLEAN OCX MDD LINK NAME (#.01) PATIENT.GLUCOPHAGE_CREAT_ (#863.3) INVLD PARENT SUBJECT (#.02) PATIENT ATTRIBUTE (#.05) GLUCO-CREATININE INVALID PARAMETER (#2) PARAMETER NAME OCXO EXTERNAL FUNCTION (#.01) CALL VALUE (#1) GLCREAT^ORKPS(|PATIENT IEN|) PARAMETER (#2) PARAMETER NAME OCXO UP-ARROW PIECE (#.01) NUMBER VALUE (#1) 4 OCX MDD ATTRIBUTE NAME (#.01) GLUCO-CREATININE INVALID (#863.4) PARAMETER (#1) PARAMETER NAME DATA TYPE (#.01) VALUE (#1) BOOLEAN Modified File Entries Associated: File Name (Number) Field (Number) Value (*=New) ------------------ -------------- ------------- ORDER CHECK RULE NAME (#.01) GLUCOPHAGE - LAB RESULTS (#860.2) STATUS (#.02) ACTIVE TRUTH ELEMENTS (#1) LABEL (#.01) GLUCOPHAGE ORDER TYPE (#.02) SIMPLE DEFINITION ELEMENT NAME (#.1) GLUCOPHAGE ORDER TRUTH ELEMENTS (#1) LABEL (.01) GLUCOPHAGE CREATININE > 1.5 TYPE (#.02) SIMPLE DEFINITION ELEMENT NAME (#.1) GLUCOPHAGE CREATININE > 1.5 TRUTH ELEMENTS (#1) LABEL (#.01) NO GLUCOPHAGE CREATININE TYPE (#.02) SIMPLE DEFINITION ELEMENT NAME (#.1) NO GLUCOPHAGE CREATININE TRUTH ELEMENTS (#1) LABEL (#.01) *GLUCOPHAGE CREATININE INVALID TYPE (#.02) *SIMPLE DEFINITION ELEMENT NAME (#.1) *GLUCOPHAGE CREATININE INVALID IS TRUE RELATION ACTIONS (#2) RELATION INDEX 1 (#.01) RELATION EXPRESSION GLUCOPHAGE ORDER AND (#1) GLUCOPHAGE CREATININE > 1.5 ORDER CHECK (#2) GLUCOPHAGE-LAB RESULTS ORDER CHECK MESSAGE Metformin - Creatinine (#6) results: |RECENT GLUCOPHAGE CREATININE TEXT| RELATION ACTIONS (#2) RELATION INDEX 2 (#.01) RELATION EXPRESSION GLUCOPHAGE ORDER AND NO (#1) GLUCOPHAGE CREATININE ORDER CHECK (#2) GLUCOPHAGE-LAB RESULTS ORDER CHECK MESSAGE Metformin - no serum (#6) creatinine within past |RECENT GLUCOPHAGE CREATININE DAYS| days. See https://www.kidney fund.org/all-about- kidneys RELATION ACTIONS (#2) RELATION INDEX *3 (#.01) RELATION EXPRESSION *GLUCOPHAGE ORDER AND (#1) GLUCOPHAGE CREATININE INVALID ORDER CHECK (#2) *GLUCOPHAGE-LAB RESULTS ORDER CHECK MESSAGE *Unable to evaluate (#6) Metformin - Creatinine results: |RECENT GLUCOPHAGE CREATININE TEXT| New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): HITPS-8292 Creatinine clearance calculation error If most recent serum creatinine (SCr) is a non-numeric value, it cannot be used for display in VistA Pharmacy Headers nor CPRS Order Checks that display the most recent SCr value. Defect Tracking System Ticket(s) & Overview: 1. INC20016571 - Order Checking Most Recent Results Issue Problem: -------- When order checking searches for "most recent results", alphanumeric results might be skipped over. The search continues until a numeric result is found or no other results are found. This issue only occurs if: (1) a test result could have either numeric or alphanumeric results; and (2) the patient has multiple instances of this test result on file. For example, the result seven days ago was 1.5. The result yesterday was <1.0. In this case, the most recent result displayed would be 1.5 even though the most recent result was <1.0. Another example: The issue could also occur in a situation where a test was resulted with "NEGATIVE" seven days ago. The result yesterday was "POSITIVE". The patient only has two results on file for the test. In this case, "NEGATIVE" would display as the most recent result since it was the first result on file and there are no numeric results on file for the test. "POSITIVE" is not recognized as a valid result so the search continues through all test results and stops when it gets to the oldest result. The oldest result then displays as the most recent result. Resolution: ----------- Modify routines ORKPS and ORQQLR1 to recognize the validity of alphanumeric results when searching for most recent results during order checking. Results such as "canc" and "pending" are not deemed valid for display of "most recent results". Test Sites: ----------- Jack C. Montgomery VAMC (Muskogee, OK) Coatesville VAMC (Coatesville, PA) Test Sites - SNOW Change Order #: -------------------------------- Jack C. Montgomery VAMC: CHG0746956 Coatesville VAMC: CHG0747104 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation describing the new functionality is included in this release. Documentation can be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/. Documentation can also be obtained at https://download.vista.domain.ext/index.html/SOFTWARE. Documentation Title File Name --------------------------------------------------------------------- Computerized Patient Record System (CPRS) CPRSLMTM.PDF Technical Manual: List Manager Version Computerized Patient Record System (CPRS) CPRSLMTM.DOCX Technical Manual: List Manager Version Patch Installation: ------------------- ************************************************************************ * OR*3.0*582, PSJ*5.0*436, and PSO*7.0*695 are being * * released concurrently. * * * * OR*3.0*582 must be installed first. * * PSJ*5.0*436 and PSO*7.0*695 may be installed in any * * order after OR*3.0*582 is installed. * ************************************************************************ Pre/Post Installation Overview: This is a standard PackMan patch installation. A post-installation process will install new and modified Order Check Expert System components. The GLUCOPHAGE - LAB RESULTS in ORDER CHECK RULE (#860.2) file will be backed up to ^XTMP("ORY582") with a purge date four months from the date of installation for use in the event a back-out/roll back is needed. In order for the back-out/roll back functionality to work, sites need to use the backup type of "Build" during step B (Backup a Transport Global) of the installation instructions. Pre-Installation Instructions: This patch may be installed with users on the system, although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. Installation Instructions: 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name. (ex. OR*3.0*582). NOTE: Using will not bring up a Multi-Package build even if it was loaded immediately before this step. It will only bring up the last patch in the build. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global ii. At the Select INSTALL NAME prompt, enter your build OR*3.0*582 iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build (including Routines) R Routines Only Backup Type: B// iv. When prompted "Do you wish to secure this message? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer . ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer . iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer . Post-Installation Instructions: There are no post-installation steps required. Back-Out/Roll Back Plan: ------------------------ In the event of a catastrophic failure, the final decision to back-out this patch will be up to the site management. To back-out the patch, it is imperative that the backup was performed as specified above. Installing the backup patch will remove the new Order Check Expert System components, restore the GLUCOPHAGE - LAB RESULTS in ORDER CHECK RULE from ^XTMP("ORY582"), as well as remove/restore all routines to pre-patch conditions. Thus, completing the back-out process. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[Patch List]**;Dec 17, 1997;Build 9 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: ORKPS Before:B104632974 After:B147455838 **6,32,74,94,123,141,190,232, 316,272,346,345,382,469,582** Routine Name: ORQQLR1 Before: B16256943 After: B17794644 **6,51,74,143,414,582** Routine Name: ORY582 Before: n/a After: B2762536 **582** Routine Name: ORY5820 Before: n/a After: B15693213 **582** Routine Name: ORY58201 Before: n/a After: B71169478 **582** Routine Name: ORY58202 Before: n/a After: B78034185 **582** Routine Name: ORY58203 Before: n/a After: B78882406 **582** Routine Name: ORY58204 Before: n/a After: B82178674 **582** Routine Name: ORY58205 Before: n/a After: B61530746 **582** Routine Name: ORY58206 Before: n/a After: B65039145 **582** Routine Name: ORY58207 Before: n/a After: B69309787 **582** Routine Name: ORY58208 Before: n/a After: B17675409 **582** Routine Name: ORY5821 Before: n/a After: B40626523 **582** Routine Name: ORY5822 Before: n/a After: B26767618 **582** Routine Name: ORY5823 Before: n/a After: B12999292 **582** Routine Name: ORY5824 Before: n/a After: B13529364 **582** Routine Name: ORY582ES Before: n/a After: B12654848 **582** Routine list of preceding patches: 414, 469 ============================================================================= User Information: Entered By : Date Entered : JAN 04, 2022 Completed By: Date Completed: JUL 14, 2026 Released By : Date Released : JUL 21, 2026 ============================================================================= Packman Mail Message: ===================== $END TXT